Health

Tech could offer the NHS 'quick wins'

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The relationship between the NHS and information technology has not always been smooth.

But, in this week's Scrubbing Up Dr Rob Watson says we shouldn't give up hope - and there is potential for technology to improve the way the health service works, for doctors and patients.

I couldn't believe it when I first started practising medicine. I'd never seen a fax machine before.

Things didn't get any better: what's a pager? When I made a to-do list at work, it was on a piece of paper kept in my back pocket. I'd draw little squares and fill them in as I completed jobs. Who does that?

At handover, I'd have to frantically scribble details down while the doctor handing over to me told me about the case, listing the tasks while ensuring that I spelled the name correctly - is that really the most efficient way to transfer high-value information?

And when I was on call the bleep would constantly interrupt any conversations, decisions or resuscitations. What if it goes off when you're in the middle of putting in a catheter? You don't answer, of course. So the poor nurse who's trying to contact you has to wait for you to call them back.

Or maybe when you do call back you don't get to the person that bleeped you.

Even if you do, the chances are they won't have the patient details to hand. Or you don't have your list to hand. Or your pen. You left it on the last ward; it fell out of your pocket at that cardiac arrest.

All the time getting interrupted, jobs piling up. Surely it doesn't have to be like this?

Well, maybe not. During my work as co-author on the Nuffield Trust report, Delivering the Benefits of Digital Healthcare, my eyes were opened to another way of doing things.

While technology is not a magic bullet that will obliterate all of the NHS's woes by next Monday, there are some potential "quick wins" - measures that should be quick to implement and could bring real and rapid benefits.

Putting, say a patient's vital signs (such as pulse rate and blood pressure) into an iPad or similar means the software could spot any deterioration in a patient's condition.

If this is the case, a doctor or a senior nurse will be automatically alerted and will receive, directly to their mobile device, the patient's details, location and recent results.

All of this can be sent without the nurse leaving the bedside, allowing them to stay with the patient.

No bleeps. No writing things down (incorrectly). No need to fight for a computer to check some recent blood results.

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Image caption The way things were

With task management software, the nurses can input tasks (like 'please prescribe more fluids') that will automatically get delivered to the right clinician - and if they are busy with another patient, the task can be re-assigned to someone else.

That way the work is spread more evenly, the ward staff know that the job will be done, and one doctor won't be left with tasks stacking up that they are unable to get to for hours.

This technology could transform the way we work: a tool that facilitates the handover of all jobs at the touch of a button.

Sure, it's still important to discuss cases verbally, but the receiving doctor could actually listen rather than having to write everything down.

There are many other possibilities; a tool that automatically alerts clinicians to abnormal blood test results, tools that flag up a risk of sepsis, acute kidney injury or diarrhoeal illness, one that requests specialty referrals. The list goes on.

Last year there were two peer-reviewed evaluations of an electronic vital signs monitoring system. One found that the introduction of the monitoring system was associated with a reduction of over 700 deaths in one year at two NHS hospitals, while the other showed that the infection prevention tool was associated with a reduction in norovirus outbreaks by 90% across an NHS trust.

I suppose it is also important not to get too carried away. I've never used these systems so haven't been party to glitches or technical issues, although colleagues I spoke to mentioned difficulties with Wi-Fi blackspots and some patients not being on the system.

Let's be optimistic. These new monitoring techniques really do sound like it had the potential to improve care, efficiency and productivity'

However the state of technology in some hospitals is frankly embarrassing. In many cases it makes the work of frontline staff far harder than it needs to be.

For once, give us technologies that will transform the way we work. I really can't wait to try them.

Robert Watson is a junior doctor who was on an academic placement at the Nuffield Trust.

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